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F5. Skin microvascular dysfunction in preeclampsia persists to the postpartum period



F5. Skin microvascular dysfunction in preeclampsia persists to the postpartum period



Journal of Maternal-Fetal & Neonatal Medicine 29(Sup2): 30-30



Preeclampsia is a multisystem disorder characterised by endothelial and microvascular dysfunction that develops in ∼10% of pregnancies. This study will characterise skin microvascular reactivity using laser Doppler flowmetry in women with preeclampsia compared to matched controls during pregnancy and early postpartum. Women were recruited and studied on the diagnosis of preeclampsia and followed up for 6-months during postpartum period. Controls were matched for age, gestation and comorbidities. Skin blood flow corrected for mean arterial pressure (cutaneous vascular conductance; CVC) was measured using laser Doppler flowmetry (Periflux5000, Perimed AB, Sweden) on the dominant forearm. We measured the vasodilatory response to iontophoresis of acetylcholine (ACh; endothelial dependent) and sodium nitroprusside (SNP; endothelial independent) as well as local heating (initial axon-reflex and secondary nitric oxide-mediated). Results were analysed using repeated measures ANOVA. Fourteen women with preeclampsia and 15 controls were included in this analysis. Compared to controls, women with preeclampsia had significantly decreased baseline CVC during pregnancy, which persisted to the postpartum (p < 0.01). There was a significant increase in the ratio of maximum vasodilatory response to ACh and SNP at both time points (p < 0.01). There was a trend towards a higher initial axon-reflex response to heat (p = 0.05), but no difference in the secondary peak response. This study is the first to demonstrate a significantly increased response to ACh compared to SNP during pregnancy that persisted in the postpartum period. In addition, we demonstrated that the response to heat may not recover in the early postpartum period. These findings indicate persistent microvascular dysfunction in women with preeclampsia.

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Accession: 057851899

Download citation: RISBibTeXText

PMID: 27680811

DOI: 10.1080/14767058.2016.1234790


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